2. Complete the Combined Registration Agreement & Change Form
The Vermont Advance Directive Registry's (VADR) Combined Registration Agreement & Change Form gives the Registry permission to create your account and to share copies of your document with authorized healthcare professionals when needed. If you are submitting your document for registration or update via mail, fax, or email, please complete the VADR Registration Agreement/Authorization to Change form and include it with the copy of your directive that you submit.
How do I know if I should complete the Registration Agreement or the Authorization to Change section? Learn about this choice.
If you are submitting your document via user upload on the VADR website, this Combined Registration Agreement & Change Form is not required. You will give permission for account creation and document access online.
Learn about user upload
Combined Registration Agreement & Change Form
3. Submit your advance directive for registration
Registering a copy of your advance directive is free for all Vermont residents. The Vermont Advance Directive Registry (VADR) is a secure online database that is part of the national US Advance Care Plan Registry (USACPR, formerly the US Living Will Registry). Registering a copy of your advance directive allows authorized health care facilities and providers quick access when it is most needed. You are not required to register a copy of your advance directive, and your directive is valid as soon as signing and witnessing is properly completed.
To register your advance directive, please choose your preferred submission method:
User Upload
- Upload a PDF of your document yourself using User Upload. The VADR’s Create My Account option allows you to create your account online, and upload a PDF copy of your completed advance directive.
- Create your account.
If you register via user upload, the VADR Registration Agreement/Authorization to Change form is not required. If you do use this option, you will give permission to create and update your account online during the upload process.
Mail, Fax or Email
If you are not able to use the user upload process above, there are updated options to mail, fax or email your submission for registration.
If you are submitting your document via mail, fax, or email, you must also include a signed and completed VADR Registration Agreement/Authorization to Change form. This form can also be requested via phone by calling 1-802-828-2909.
MAIL:
Vermont Ethics Network
61 Elm Street, Suite 1
Montpelier, VT 05602
FAX: 1-802-828-2646
EMAIL: [email protected]
Phone or email requests for account support or new advance directive paperwork are now being received at 1-802-828-2909 or [email protected].
Documents sent to the Westfield, New Jersey address or to the prior submission email or fax number are still being received and will be processed as usual. If you have sent your document to the New Jersey address, you may experience a slight delay in receiving your confirmation letter via mail.
Change Your Advance Directive
Access your registered advance directive
You can log into your personal account with the username and password you created when you set up your registry account OR refer to the login instructions on your most recent letter from the registry.
Personal Account Login
You can use your personal account to:
- Download, view and print your document(s).
- Email or fax a copy of your document.
- Confirm that your document is current and still reflects your wishes.
Make changes to your advance directive
Complete a new advance directive form. The new advance directive must be signed and witnessed. In addition to submitting your new directive to the VADR, send copies of the new document to anyone with a copy of your previous advance directive.
If you have access to a computer, you can upload a PDF copy your new directive by logging in to your account and selecting ‘Upload or Replace My Documents’.
Go to Log In page
If you need help logging in to your account, please follow the password reset instructions on the log in page. If you need further assistance, please email [email protected] or call 1-802-828-2909 .
OR
2. Email, mail or fax a copy of the newly signed advance directive form AND an Authorization to Change form* to:
- Email: [email protected]
- Mail:
Vermont Ethics Network
61 Elm Street, Suite 1
Montpelier, VT 05602 - Fax: 1-802-828-2646
*Mail, fax, and email submissions that do not include both forms will be returned by mail for correction.
Revoke the appointment of a health care agent, suspend or delete your advance directive
- Submit a written statement and a signed Authorization to Change form to the Vermont Advance Directive Registry. Provide a copy of the written statement to anyone with a copy of your advance directive.
- Mail or fax the written statement and form to:
- Mail:
Vermont Ethics Network
61 Elm Street, Suite 1
Montpelier, VT 05602 - Fax: 1-802-828-2646
- Email:[email protected]
If your submission is missing required paperwork, or is not completed properly, your submission will be returned to you via mail or email with your documents and the needed information for resubmission included. If you have questions about your submission, or about advance directives in general, please see the support options below:
Privacy Statement
The Vermont Advance Directive Registry is sensitive to the privacy of registrants, the confidentiality of their information and the documents stored for them.
The registry will provide identifying information, emergency contact information, and an exact copy of the advance directive, provided by the registrant, to any provider with a valid request that complies with the policies and procedures of the registry.
Information transmitted via the internet to your provider or healthcare facility is encrypted and secure.
Questions and Assistance
Vermont Ethics Network
For assistance with Vermont Advance Directive Registry accounts, questions about advance directives, to request forms or updated stickers for your ID, help with completing an advance directive or form, or about medical decision making:
[email protected]
(802) 828-2909 (Monday to Thursday, 9:00 am – 5:00 PM)
U.S. Living Will Registry
For help with an error message in your existing account, or if you are a provider who needs access to a patient’s directive:
[email protected]
(888) 548-9455 (Monday to Friday, 9:00 am – 5:00 PM)
New Wallet ID Cards are automatically sent out ONLY if you have changed your name, primary emergency contact, or date of birth. You will not automatically get a new card for other updates. If you need to order a new card, you can do so by logging in to your account and selecting ‘Order New Wallet ID”. If you cannot log in to your account, please call 1-802-828-2909 or email [email protected] for assistance.